Intellectual Disability
Characterized by limitations in intellectual functioning or adaptive behavior as expressed in conceptual, social, and practical adaptive skills that develop before the age of 18
Intellectual Functioning
Involves the mental capacity for learning, reasoning, and problem-solving
Adaptive behavior
Conceptual, social, and practical skills
Inntellectual Disabilites can be in what areas?
- Reading
- Math
- Writing
- Motor Skill Deficits
- Language Deficits
- Auditory and Visual Processing Issues
Mild vs. Severe Intellectual Disabilities
Mild: Challenges in a few of these areas
Severe: Challenges in all of the areas described
Down-Syndrome
Tyoe of genetic intellectual disability
Who is “at risk” for developmental delay (often referred to as global developmental delay)?
Infants at higher risk include
- Premature infants
- Those infants with perinatal complications, other known health conditions, or maternal factors
- Infants with low socioeconomic family factors
What is the basis for early identification of developmental delay?
- Significant delays in acquisition of age-appropriate developmental milestones in language, motor and social-adaptive skill development
- Developmental delay is defined as a young child’s inability to meet age-appropriate expectations based on a typical developmental progression.
- Ex. Delayed responsiveness to auditory and visual in first. months of life, poor suck for feeding, hyper or hypotonicity leading to delays in head control, sitting, or standing and delays in language acquisition
How is global developmental delay identified in the young child?
- Monitoring of developmental progression (Early Intervention referral, pediatrician record of developmental milestones)
- Multidisciplinary team screening and evaluation (recognition of caregiver concerns) Example: Developmental Screening Assessment, such as the Ages & Stages Questionairre
What are additional Best Practice Approaches for children identified with developmental delay?
- Parent/ caregiver education and support
- Provide neonatal hearing and vision screening and evaluation follow up
- Maintain consistent well-child health (pediatrician) follow up
- Multidisciplinary team approach; to include early childhood educators and psychology
Intellectual disability (ID) replaced the term…
“Mental Retardation” after the passing of U.S Federal law, known as Rosa’s Law
An ID diagnosis must include the following:
- An intellectual impairment supported by IQ testing
- Adaptive Behavior deficits
- Onset during the developmental period; typically under age 5
Adaptive skill impairment
The child’s inability to adapt or function in daily living skills when compared with same age peers of the same culture.
-Such impairments may limit the child’s participation in daily occupations such as communication, social participation, school participation, and self care with home and community.
How is Adaptive Skill Impairment identified?
- The AAIDD definition of intellectual disability requires deficits in at least one of the three domains of adaptive behavior.
- Adaptive skill performance is measured using standardized and psychometrically sound assessments
Conceptual Domains (adaptive skill impairments)
- Expressive Language
- Literacy
- Numeracy
Social Skill Domain (adaptive skill impairments)
- Interpersonal skills
- Social problem solving
- Rule-following
Practical Domain (adaptive skill impairments)
- ADL Skills
- IADLs
- Occupational Skills
How is intellectual and adaptive skill performance of young children measured?
Two standard deviations on either side of the mean makes up approx. 95% of the population and defines the range of typical intellectual functioning.
Average IQ score is…
- Given a 15 point standard deviation on most IQ tests, an individual scoring greater than 2 standard deviations below the mean, or below an IQ of 70-75 may be considered to have an intellectual disability.
- Based on IQ levels: mild, moderate, severe, profound
An intellectual disability diagnosis must include a…
Psychometric measure of both intellectual functioning and adaptive skill performance and must occur during the developmental period. (0-5 yrs)
Mild intellectual disability
(IQs of 50-70)
- Linked with socioeconomic and familiar factors i.e., poverty and poor nutrition.
- Common biological factors include perinatal complications, prenatal alcohol and drug exposure.
Severe Intellectual Disability
(IQs of less than 50)
- Linked with more biological or genetic factors
(ex. Trisomy 21 or Down’s Syndrome, fragile X syndrome, and fetal alcohol syndrome) - Identifiable in greater than 75% of children diagnosed.
Most commonly used psychological assessments for children
- Bayley Scales of Infant Development (BSID-III)
- Wechsler Preschool and Primary Scale of Intelligence (4th Ed)
- Wechsler Intelligence Scale for Children (5th Ed)
Most commonly used assessment of adaptive behavior
- Vineland 3
- Scales of Independent Behavior
- Adaptive Behavior Assessment System
